tbuckley/cabot-search huggingface dataset:
Loco-regional therapies competing with radiofrequency ablation in potential indications for hepatocellular carcinoma: a network meta-analysis
Authors: Ha Il Kim, Jihyun An, Seungbong Han, Ju Hyun Shim
Journal: Clinical and Molecular Hepatology (2023)

Background/Aims: There is no clear consensus on the relative ranking of interventional and radiation techniques with indications similar to those of radiofrequency ablation (RFA) for the treatment of early hepatocellular carcinoma (HCC). We used a network meta-analysis to compare the efficacy of non-surgical treatments for early HCC.Methods: We searched databases for randomized trials assessing the efficacy of loco-regional treatments for HCCs ≤5 cm with no extrahepatic spread or portal invasion. The primary outcome was the pooled hazard ratio (HR) for overall survival (OS), and secondary outcomes included overall and local progression-free survival (PFS). A frequentist network meta-analysis was performed, and the relative ranking of therapies was assessed with P-scores.Results: Nineteen studies comparing 11 different strategies in 2,793 patients were included. Chemoembolization plus RFA improved OS better than RFA alone (HR 0.52, 95% confidence interval [CI] 0.33–0.82; P-score=0.951). Cryoablation, microwave ablation, laser ablation, and proton beam therapy had similar effects on OS compared with RFA. For overall PFS, but not local PFS, only chemoembolization plus RFA performed significantly better than RFA (HR 0.61, 95% CI 0.42–0.88; P-score=0.964). Injection of percutaneous ethanol or acetic acid was significantly less effective than RFA for all measured outcomes, while no differences in progression outcomes were identified for other therapies included in the network.Conclusions: Our results suggest that chemoembolization combined with RFA is the best option for local treatment of early HCC. Cases with potential contraindications for RFA may benefit from a tailored approach using thermal or radiation modalities.
New considerations and implications with weekly patient-reported symptom monitoring and eczema severity
Authors: William Hao Syuen Ng, Saxon D Smith
Journal: British Journal of Dermatology (2023)

Journal Article Corrected proof New considerations and implications with weekly patient-reported symptom monitoring and eczema severity Get access William Hao Syuen Ng, William Hao Syuen Ng Monash Health, Clayton, VIC, Australia Correspondence: William Hao Syuen Ng. Email: williamnhsofficial@gmail.com https://orcid.org/0000-0002-6508-9427 Search for other works by this author on: Oxford Academic Google Scholar Saxon D Smith Saxon D Smith ANU Medical School, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia https://orcid.org/0000-0003-0995-4372 Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, ljad219, https://doi.org/10.1093/bjd/ljad219 Published: 03 July 2023 Article history Received: 12 June 2023 Published: 03 July 2023 Corrected and typeset: 28 July 2023
Sex- and Age-Based Disparities in Public Access Defibrillation, Bystander Cardiopulmonary Resuscitation, and Neurological Outcome in Cardiac Arrest
Authors: Masanobu Ishii, Kenichi Tsujita, Tomohisa Seki, Masafumi Okada, Kazumi Kubota, Kenichi Matsushita, Koichi Kaikita, Naohiro Yonemoto, Yoshio Tahara, Takanori Ikeda
Journal: JAMA Network Open (2023)

Importance Younger females with out-of-hospital cardiac arrest (OHCA) in public locations have less likelihood to receive public access defibrillation and bystander cardiopulmonary resuscitation (CPR). However, the association between age- and sex-based disparities and neurological outcomes remains underexamined. Objective To investigate the association between sex and age and the rate of receiving bystander CPR, automated external defibrillator defibrillation, and neurological outcomes in patients with OHCA. Design, Setting, and Participants This cohort study used the All-Japan Utstein Registry, a prospective, population-based, nationwide database in Japan containing data on 1 930 273 patients with OHCA between January 1, 2005, and December 31, 2020. The cohort comprised patients with OHCA of cardiac origin that was witnessed by citizens and treated by emergency medical service personnel. The data were analyzed from September 3, 2022, to May 5, 2023. Exposure Sex and age. Main Outcomes and Measures The primary outcome was favorable neurological outcome at 30 days after an OHCA. Favorable neurological outcome was defined as a Cerebral Performance Category score of 1 (indicating good cerebral performance) or 2 (indicating moderate cerebral disability). The secondary outcomes were the rates of receiving public access defibrillation and bystander CPR. Results The 354 409 included patients who experienced bystander-witnessed OHCA of cardiac origin had a median (IQR) age of 78 (67-86) years and 136 520 were females (38.5%). The rate of receiving public access defibrillation was higher in males than females (3.2% vs 1.5%; P &amp;amp;lt; .001). Stratified by age, age- and sex-based disparities in prehospital lifesaving interventions by bystanders and in neurological outcomes were observed. Although younger females had a lower rate of receiving public access defibrillation and bystander CPR than males, younger females had a higher favorable neurological outcome compared with males of the same age (odds ratio [OR], 1.19; 95% CI, 1.08-1.31). In younger females with OHCA that was witnessed by nonfamily bystanders, receiving public access defibrillation (OR, 3.51; 95% CI, 2.34-5.27) or bystander CPR (OR, 1.62; 95% CI, 1.20-2.22) was associated with a favorable neurological outcome. Conclusions and Relevance Results of this study suggest a pattern of significant sex- and age-based differences in bystander CPR, public access defibrillation, and neurological outcomes in Japan. Improvement in neurological outcomes in patients with OHCA, especially younger females, was associated with increased use of public access defibrillation and bystander CPR.
Is lirentelimab the ‘magic bullet’ to fight pathological mast-cell activation in systemic mastocytosis?
Authors: Stéphane Barete, Michel Arock
Journal: British Journal of Dermatology (2023)

Journal Article Corrected proof Is lirentelimab the ‘magic bullet’ to fight pathological mast-cell activation in systemic mastocytosis? Get access Stéphane Barete, Stéphane Barete Reference center for mastocytosis (CEREMAST), AP-HP, GH Pitié-Salpêtrière, 47–83 bd de l’Hôpital 75013 Paris and Sorbonne Université, Paris Correspondence: Stéphane Barete. Email: stephane.barete@aphp.fr https://orcid.org/0000-0003-1593-9750 Search for other works by this author on: Oxford Academic Google Scholar Michel Arock Michel Arock Reference center for mastocytosis (CEREMAST), AP-HP, GH Pitié-Salpêtrière, 47–83 bd de l’Hôpital 75013 Paris and Sorbonne Université, Paris Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, ljad227, https://doi.org/10.1093/bjd/ljad227 Published: 05 July 2023 Article history Received: 27 June 2023 Accepted: 03 July 2023 Published: 05 July 2023 Corrected and typeset: 10 August 2023
FDA Approval Summary: Axicabtagene Ciloleucel for Second-Line Treatment of Large B-Cell Lymphoma
Authors: Poornima Sharma, Yvette L. Kasamon, Xue Lin, Zhenzhen Xu, Marc R. Theoret, Tejashri Purohit-Sheth
Journal: Clinical Cancer Research (2023)

Abstract In April 2022, the FDA approved axicabtagene ciloleucel (axi-cel) for adults with large B-cell lymphoma (LBCL) that is refractory to first-line chemoimmunotherapy or that relapses within 12 months of first-line chemoimmunotherapy. Approval was based on ZUMA-7, a randomized (1:1), open-label trial in 359 patients with primary refractory LBCL (74%) or early relapse who were transplant candidates. The study compared a single course of axi-cel to standard therapy, consisting of chemoimmunotherapy followed by high-dose therapy and autologous hematopoietic stem cell transplantation (HSCT) in responding patients. Overall, 94% of the experimental arm received chimeric antigen receptor (CAR) T-cell product, and 35% of the control arm received on-protocol HSCT. The primary endpoint was event-free survival, which was significantly longer in the axi-cel arm with an HR of 0.40 (95% confidence interval, 0.31–0.51; P value &amp;lt; 0.0001) and estimated median of 8.3 months, versus 2.0 months with standard therapy. Among 168 recipients of axi-cel, cytokine release syndrome occurred in 92% (Grade ≥ 3, 7%), neurologic toxicity in 74% (Grade ≥ 3, 25%), prolonged cytopenias in 33%, and fatal adverse reactions in 1.8%. This is the first FDA approval of a CAR T-cell therapy for LBCL in the second-line setting and reflects a potential paradigm shift.
Substance Use Disorder and Health Outcomes in COVID-19—The Need for a Better Research Method to Determine Substance Use Exposure—Reply
Authors: Lyna Z. Schieber, Barbara Lopes-Cardozo, Gery P. Guy
Journal: JAMA Psychiatry (2023)

Substance Use Disorder and Health Outcomes in COVID-19—the Need for a Better Research Method to Determine Substance Use Exposure
Assessment of Oxygen Pulse in Hypertrophic Cardiomyopathy
Authors: Jan Gerrit van der Stouwe, Christian M. Schmied, David Niederseer
Journal: JAMA Cardiology (2023)

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When taking iron, a glass of orange juice a day keeps anemia away
Authors: Jacquelyn M. Powers, Michael Auerbach
Journal: American Journal of Hematology (2023)

JMP discloses consultancy for Pharmacosmos LLC. MA discloses research funding for data management from Covis Pharma, and educational, non-promotional programs for Pharmacosmos. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
A Patient in Their 70s With Bright Red Blood in the Pericardiocentesis Catheter
Authors: Tomislav Tokic, Ivan Burcar, Hrvoje Gasparovic
Journal: JAMA Cardiology (2023)

This case report discusses a finding of blood in the pericardiocentesis catheter of a patient with a recent history of aortic valve replacement and recurrent postsurgical pericardial and pleural effusions.
Leveraging national and global political determinants of health to promote equity in cancer care
Authors: Edward Christopher Dee, Michelle Ann B Eala, Janine Patricia G Robredo, Duvern Ramiah, Anne Hubbard, Frances Dominique V Ho, Richard Sullivan, Ajay Aggarwal, Christopher M Booth, Gerardo D Legaspi, Paul L Nguyen, C S Pramesh, Surbhi Grover
Journal: JNCI Journal of the National Cancer Institute (2023)

Abstract Health and politics are deeply intertwined. In the context of national and global cancer care delivery, political forces—the political determinants of health—influence every level of the cancer care continuum. We explore the “3-I” framework, which structures the upstream political forces that affect policy choices in the context of actors' interests, ideas, and institutions, to examine how political determinants of health underlie cancer disparities. Borrowing from the work of PA Hall, M-P Pomey, CJ Ho, and other thinkers, interests are the agendas of individuals and groups in power. Ideas represent beliefs or knowledge about what is or what should be. Institutions define the rules of play. We provide examples from around the world: Political interests have helped fuel the establishment of cancer centers in India and have galvanized the 2022 Cancer Moonshot in the United States. The politics of ideas underlie global disparities in cancer clinical trials—that is, in the distribution of epistemic power. Finally, historical institutions have helped perpetuate disparities related to racist and colonialist legacies. Present institutions have also been used to improve access for those in greatest need, as exemplified by the Butaro Cancer Center of Excellence in Rwanda. In providing these global examples, we demonstrate how interests, ideas, and institutions influence access to cancer care across the breadth of the cancer continuum. We argue that these forces can be leveraged to promote cancer care equity nationally and globally.
Prediction models for heart failure in the community: A systematic review and meta‐analysis
Authors: Ramesh Nadarajah, Tanina Younsi, Elizabeth Romer, Keerthenan Raveendra, Yoko M. Nakao, Kazuhiro Nakao, Farag Shuweidhi, David C. Hogg, Ronen Arbel, Doron Zahger, Zaza Iakobishvili, Gregg C. Fonarow, Mark C. Petrie, Jianhua Wu, Chris P. Gale
Journal: European Journal of Heart Failure (2023)

Multivariable prediction models can be used to estimate risk of incident heart failure (HF) in the general population. A systematic review and meta-analysis was performed to determine the performance of models.From inception to 3 November 2022 MEDLINE and EMBASE databases were searched for studies of multivariable models derived, validated and/or augmented for HF prediction in community-based cohorts. Discrimination measures for models with c-statistic data from ≥3 cohorts were pooled by Bayesian meta-analysis, with heterogeneity assessed through a 95% prediction interval (PI). Risk of bias was assessed using PROBAST. We included 36 studies with 59 prediction models. In meta-analysis, the Atherosclerosis Risk in Communities (ARIC) risk score (summary c-statistic 0.802, 95% confidence interval [CI] 0.707-0.883), GRaph-based Attention Model (GRAM; 0.791, 95% CI 0.677-0.885), Pooled Cohort equations to Prevent Heart Failure (PCP-HF) white men model (0.820, 95% CI 0.792-0.843), PCP-HF white women model (0.852, 95% CI 0.804-0.895), and REverse Time AttentIoN model (RETAIN; 0.839, 95% CI 0.748-0.916) had a statistically significant 95% PI and excellent discrimination performance. The ARIC risk score and PCP-HF models had significant summary discrimination among cohorts with a uniform prediction window. 77% of model results were at high risk of bias, certainty of evidence was low, and no model had a clinical impact study.Prediction models for estimating risk of incident HF in the community demonstrate excellent discrimination performance. Their usefulness remains uncertain due to high risk of bias, low certainty of evidence, and absence of clinical effectiveness research.
Associations Between Objective and Subjective Experiences of Childhood Maltreatment and the Course of Emotional Disorders in Adulthood
Authors: Andrea Danese, Cathy Spatz Widom
Journal: JAMA Psychiatry (2023)

Importance A history of childhood maltreatment is associated with an unfavorable course of illness for emotional disorders. However, the origins and mechanisms underlying these associations are unknown. Objective To examine the relative associations of objective and subjective measures of childhood maltreatment and continuity in psychopathology with the course of emotional disorders in adulthood. Design, Setting, and Participants This prospective cohort study followed up until age 40 years participants residing in a metropolitan county of the US Midwest with substantiated records of childhood physical and sexual abuse and/or neglect between 1967 and 1971 and a demographically matched group of participants experiencing no abuse or neglect in childhood. The collected data were analyzed between October 2021 and April 2022. Exposures The objective experience of childhood maltreatment before age 12 years was prospectively measured through official court records, whereas the subjective experience was measured through retrospective self-report at a mean (SD) age of 29 (3.8) years. Current and previous lifetime psychopathology was also assessed at a mean age of 29 (3.8) years. Main Outcomes and Measures Symptoms of depression and anxiety were measured at mean (SD) ages of 39.5 (3.5) and 41.2 (3.5) years using Poisson regression models. Results In a cohort of 1196 participants (582 [48.7%] female and 614 [51.3%] male) followed up to age 40 years, those with objective plus subjective measures of childhood maltreatment had a greater number of subsequent follow-up phases with depression or anxiety than controls (depression: incidence rate ratio [IRR], 2.28 [95% CI, 1.65-3.15]; anxiety: IRR, 2.30 [95% CI, 1.54-3.42]), as did those with subjective-only measures (depression: IRR, 1.49 [95% CI, 1.02-2.18]; anxiety: IRR, 1.58 [95% CI, 0.99-2.52]). In contrast, participants with objective-only measures did not have a greater number of follow-up phases with depression or anxiety (depression: IRR, 1.37 [95% CI, 0.89-2.11]; anxiety: IRR, 1.40 [95% CI, 0.84-2.31]). Current and lifetime psychopathology measured at the time the subjective experience was assessed explained its association with a later course of emotional disorders in participants with subjective-only measures but not in those with objective plus subjective measures. Conclusions and Relevance In this cohort study, the associations seen between childhood maltreatment and poor course of emotional disorders over the subsequent decade were largely attributable to the subjective experience of maltreatment, which was partly explained by continuity in psychopathology. Modification of the subjective experience of childhood maltreatment could improve the longitudinal course of emotional disorders.
Acquired Secondary <i>HER2</i> Mutations Enhance HER2/MAPK Signaling and Promote Resistance to HER2 Kinase Inhibition in Breast Cancer
Authors: Arnaldo Marín, Abdullah Al Mamun, Hima Patel, Hiroaki Akamatsu, Dan Ye, Dhivya R. Sudhan, Lisa Eli, Katherine Marcelain, Benjamin P. Brown, Jens Meiler, Carlos L. Arteaga, Ariella B. Hanker
Journal: Cancer Research (2023)

Abstract HER2 mutations drive the growth of a subset of breast cancers and are targeted with HER2 tyrosine kinase inhibitors (TKI) such as neratinib. However, acquired resistance is common and limits the durability of clinical responses. Most HER2-mutant breast cancers progressing on neratinib-based therapy acquire secondary mutations in HER2. It is unknown whether these secondary HER2 mutations, other than the HER2T798I gatekeeper mutation, are causal to neratinib resistance. Herein, we show that secondary acquired HER2T862A and HER2L755S mutations promote resistance to HER2 TKIs via enhanced HER2 activation and impaired neratinib binding. While cells expressing each acquired HER2 mutation alone were sensitive to neratinib, expression of acquired double mutations enhanced HER2 signaling and reduced neratinib sensitivity. Computational structural modeling suggested that secondary HER2 mutations stabilize the HER2 active state and reduce neratinib binding affinity. Cells expressing double HER2 mutations exhibited resistance to most HER2 TKIs but retained sensitivity to mobocertinib and poziotinib. Double-mutant cells showed enhanced MEK/ERK signaling, which was blocked by combined inhibition of HER2 and MEK. Together, these findings reveal the driver function of secondary HER2 mutations in resistance to HER2 inhibition and provide a potential treatment strategy to overcome acquired resistance to HER2 TKIs in HER2-mutant breast cancer. Significance: HER2-mutant breast cancers acquire secondary HER2 mutations that drive resistance to HER2 tyrosine kinase inhibitors, which can be overcome by combined inhibition of HER2 and MEK.
Trends Over Time in Medicare for Advanced Practice Clinicians in Dermatology, 2013-2020
Authors: Cassandra Mohr, Yao Li, Candice L. Hinkston, David J. Margolis, Mackenzie R. Wehner
Journal: JAMA Dermatology (2023)

Importance The number of advanced practice clinicians (APCs, including nurse practitioners and physician assistants) in the US is increasing. The effect this has on dermatology is unclear. Objective To develop a method to identify APCs practicing dermatology in claims data and to evaluate the contribution of dermatology APCs to the dermatology workforce and how this has changed over time. Design, Setting, and Participants This retrospective cohort study used the Medicare Provider Utilization and Payment Data Public Use files (2013 to 2020). As APCs are not listed by specialty, a method to identify APCs practicing dermatology was developed and validated using common dermatology procedural codes. The data were analyzed from November 2022 to April 2023. Main Outcomes and Measures The proportion of clinicians and office visits by dermatology APCs and physician dermatologists were evaluated using Mann-Kendall tests. Joinpoint analysis was also used to compare the average annual percentage change of dermatology procedures and clinicians in rural-urban areas between dermatology APCs and physician dermatologists. Results The method to identify APCs practicing dermatology had 96% positive predictive value, 100% negative predictive value, 100% sensitivity, and 100% specificity. Between 2013 and 2020, 8444 dermatology APCs and 14 402 physician dermatologists were identified. They provided 109 366 704 office visits in Medicare. The percentage of dermatology clinicians who were APCs increased over time, from 27.7% in 2013 to 37.0% in 2020 ( P = .002). The proportion of dermatologic office visits provided by APCs also increased over time, from 15.5% in 2013 to 27.4% in 2020 ( P = .002). For all procedure categories, the average annual percentage change was positive for dermatology APCs (range, 10.05%-12.65%) and was higher than that of physician dermatologists. For all rural-urban designations, the average annual percentage change was positive for dermatology APCs (range, 2.03%-8.69%) and was higher than metropolitan, micropolitan, and small-town areas from that of physician dermatologists. Conclusions and Relevance In this retrospective cohort study, there was a temporal increase in the amount of dermatologic care provided by APCs in Medicare. These findings demonstrate changes in the dermatology workforce and may have implications for dermatology as a specialty.